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Mental health officials are reaching out to offer support and counseling to these people who were exposed to the kind of violence normally associated with war zones.

Karla Fierro was in a statistics class on July 7 when El Centro College was evacuated during the shooting after a peaceful Black Lives Matter rally downtown. Five Dallas police officers were killed in the shooting. Fierro was evacuated to a parking garage across Main Street with the protection of armed police officers. She and others stayed there for two hours. (Andy Jacobsohn/The Dallas Morning News)(Staff Photographer)

Jose Morales has been replaying the moments of the evening of July 7 over and over in his mind. Finishing his test in an eighth-floor classroom at El Centro College. Hearing popping sounds from the street below. Looking out a window and seeing people running. Riding the elevator to the ground floor.

The next moment, captured on a phone video by a classmate, shows Morales peeking out of the elevator. Police officers point their guns at him and shout, “Hands up! Hands up!” Morales starts to raise his hands, then hesitates. In his left hand, he’s holding a phone. He takes a moment to stuff it in his pants, then raises both his hands. It takes only a split second.

Now, only days later, does he realize how that moment of hesitation -- that one quick move to his pocket -- could have cost him his life. How police might have thought he was the suspect reaching for a gun. “It started to sink in the next morning. I could have been killed for that stupid mistake,” said Morales, 22, a Seagoville resident pursuing a nursing career.

Morales was one of hundreds caught in the crossfire during the July 7 shooting that killed five police officers, wounded several others and sent crowds screaming and running for safety. The massacre took place near the end of a march protesting police shootings of black men.

Those, like Morales, who survived the attack may face the ripple effects of trauma -- from short-term stress to long-term anxiety disorders. Mental health officials are reaching out to offer support and counseling to these people who were exposed to the kind of violence normally associated with war zones.

Dr. Carol North, professor of psychiatry at UT Southwestern, is an expert on on how people react to mass shootings. She’s studied thousands of victims of more than a dozen different disasters. Nearly everyone exposed to the level of violence seen in the Dallas ambush will be affected to one degree or another; some might develop post-traumatic stress disorder, or PTSD, a serious condition, but treatable.

Less than 1 in 5 people exposed to a traumatic event will develop PTSD, but many will experience symptoms for a short time, North said. These include hyperarousal, or jumpiness; nightmares; sleeplessness; persistent thoughts and avoidance of places that cause anxiety. “Those symptoms, by themselves, do not indicate psychiatric illness,” she said.

By definition, PTSD is diagnosed only when these symptoms continue for a month or longer.

In studies of people directly exposed to the Oklahoma City bombing and the 9/11 attacks on the World Trade Center, North found that nearly all had one or more symptoms of PTSD, but only about a third developed PTSD. In mass shootings she has studied, the rates of those exposed to the event who developed PTSD were slightly under 20 percent.

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But you can’t go through a terrible event such as the Dallas shooting without being affected in some way. “Our data shows that almost everybody who is exposed to one of these horrible, traumatic events gets upset,’’ North said.

It’s less common for people to report feeling emotionally numb or overwhelmed with anxiety and wanting to avoid places that trigger reminders of the trauma. Such “numbing and avoidance” symptoms are a strong indicator of PTSD, North said.

Morales said it took him a few days to calm down. “I’m a guy who doesn’t party, doesn’t get into mischief, doesn’t have a criminal record,” he said. “One minute, I’m taking a test. The next minute there are guns pointed at me.”

A fellow El Centro classmate that evening, Karla Fierro, also needed time to feel normal. “The first few days, I was still kind of like shaky,” she said. A junior at the University of Texas at Arlington, Fierro wanted to get ahead by taking a summer semester class in statistics at El Centro.

The scariest part of the evening came when she stepped out of the elevator and saw cops with guns drawn. “I think my pulse was exploding just then,” she said. Seeing windows and glass doors shattered by gunshots and police officers everywhere alarmed her. “We knew then we were caught in the middle of something terrible.”

For 30 minutes, Fierro and the others huddled against the El Centro building facing Main Street while police figured out what to do with them. Then, with police surrounding them, the students raced across the street to a parking garage and took shelter there, first in a stairwell and then in a boiler room.

The students stayed put for more than two hours. Karla sent and received texts to anxious family members and friends. She read news updates on her phone. Around midnight, the police sent them toward the Omni Dallas Hotel, where she finally reunited with her mother.

Fierro and others at El Centro that night have been offered psychological counseling by the college. She has also received support and offers of counseling from the University of Texas at Arlington, where she’s working on a degree in criminal justice. Her mother thinks she should take advantage of the offers and she plans to do so, she said.

She recently came downtown for the first time since the shooting. She walked past El Centro and saw the new glass doors that replaced the ones shattered by bullets. All of this left her with an eerie feeling. She knows her own psyche won’t be so easily fixed. “I feel fine now, but you can never be too sure.”

1/3Jermar Taylor, 12, broke down as he recalled the confusion during the July 7 attack Thursday night that killed five police officers and wounded seven more, including his mother, Shetamia Taylor (right). They were at a news conference at Baylor Scott & White Health Center in Dallas.. (Marcus Yam/Los Angeles Times)

2/3Jermar Taylor, 12, center, breaks down as he recalls the confusion during the attack Thursday night that killed five police officers and wounded seven more, including his mother, Shetamia Taylor, right, during a press conference at Baylor Scott & White Health Center in Dallas on Sunday, July 10, 2016. (Marcus Yam/Los Angeles Times/TNS)(TNS)

3/3Jermar Taylor, 12, center, breaks down as he recalls the confusion during the attack Thursday night that killed five police officers and wounded seven more, including his mother, Shetamia Taylor, right, during a press conference at Baylor Scott & White Health Center in Dallas on Sunday, July 10, 2016. (Marcus Yam/Los Angeles Times/TNS)(TNS)

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Among the marchers that Thursday night was Shetamia Taylor, 38, of Garland, who had brought her four sons with her. After the shooting began, she felt a bullet tear into her right calf. Her 15-year-old son, Andrew, turned to help her and she pulled him down with her behind a car. As the gunshots continued, several officers shielded them.

Taylor spent three days at Baylor University Medical Center. She still feels anxious and hasn’t gotten a full night’s sleep since the night of the shooting, she said. At Baylor, she was given the number of a psychologist to call for counseling, and she plans to do so as soon as her leg heals.

Her four sons are acting OK — even her 15-year-old, who was covered in her blood as she lay over him to shield him from bullets. They’re trying to act “macho” for their mom, “so I don’t worry,” Taylor said. But she is apprehensive — especially about the long-term effects. “That is my absolute No. 1 concern.”

Taylor is not taking any chances and plans to take her sons to see the Baylor psychologist. Her church, Mount Hebron Missionary Baptist, in Garland, also has counselors they could see, she said.

“I would never let them get away with just saying, ‘We’re OK.’ ” she said. “I want that to be true. But let’s make sure of it.”

David Tarrant. Enterprise writer at The Dallas Morning News.
Telling stories about ordinary people involved in extraordinary events is his passion. He has written about soldiers returning home from war and the mental health crisis facing young people. A native of Pittsburgh, Pa., he remains obsessively curious about Texans and the Lone Star State culture.